How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $575.44 Median $1,047.13 Typical High $7,762.47 | Facility | None | $575.44 | $1,047.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $812.83 | Professional | None | $549.54 | $812.83 | $812.83 |
BCBS New Mexico Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,398.83 Typical High $6,760.83 | Facility | None | $537.03 | $2,398.83 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,023.29 | Professional | None | $602.56 | $691.83 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $245.47 Typical High $338.84 | Professional | None | $50.12 | $245.47 | $338.84 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $831.76 Typical High $5,754.40 | Facility | None | $537.03 | $831.76 | $5,754.40 |
Providence Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,000.00 | Professional | None | $575.44 | $691.83 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $9,549.93 | Facility | None | $1,230.27 | $2,454.71 | $9,549.93 |
United Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $562.34 | Professional | None | $281.84 | $407.38 | $562.34 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $269.15 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $109.65 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $407.38 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $81.28 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $54.95 | $81.28 | $81.28 |
Where New Mexico sits
The same service costs 10.0 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Mexico· 33rd of 51
$603
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.